Obesity, inactivity could outpace smoking in cancer death risk

Obesity, inactivity could outpace smoking in cancer death risk

Obesity, inactivity could outpace smoking in cancer death risk

Obesity and inactivity could someday account for more cancer deaths than smoking if current trends continue, a leading cancer expert says.

As the rate of smoking decreases, other unhealthy habits threaten to offset the progress in reducing cancer deaths, says Richard Wender, a physician and chief cancer control officer at the American Cancer Society (ACS). A study in the New England Journal of Medicine last fall found 13 types of cancer were linked to excess body weight.

There’s no guarantee that obesity and inactivity will surpass smoking as a cancer cause, Wender says, but the possibility is startling.

“Who would’ve thought we’d ever see the day where what you eat (and) exercise, could account for more cancer deaths than smoking?” he asks.

The connections between smoking and too much exposure to the sun and cancer are well known, but the connections between nutrition and exercise and cancer are less known and harder to determine.

Calculating cancer’s link to obesity is difficult in part because of an overlap in cancer risk factors, says ACS’ Rebecca Siegel, While 20% of cancers are caused by poor diet, alcohol consumption, a lack of physical activity and/or excess weight, that can’t be combined with the 30% of cancer deaths caused by cigarette smoking. That’ s because poor people are more likely to be obese and to smoke than more affluent people, says Siegel, strategic director of ACS’ surveillance information services.

A striking 50% of all cancer deaths could be prevented by following the basics of a healthy lifestyle, says Wender. That includes diet and exercise and having regular cancer screenings and getting the HPV vaccine that helps prevent cervical cancer and likely oral cancer and for Hepatitis B, which can lead to liver cancer.

Wender was speaking at a recent meeting of the Council of Accountable Care Physicians, which represents the doctors who work at integrated health care systems like Kaiser Permanente and Geisinger Health, which treat and insure patients. These groups say they are better positioned to address social determinants of health that can lead to cancer — like access to healthy food — than other health systems.

After all, they don’t have to worry about whether federal programs like Medicare or Medicaid or independent commercial insurers will reimburse them, say, for connecting patients to diet and fitness professionals. They are motivated to screen patients more often for cancer, since they have to pay to treat cancer that is caught too late.

The effect of the decline in smoking on cancer “has been somewhat counterbalanced by this steady rise in obesity trends beginning in the ’70s,” says Wender. The obesity rate has tripled since the early 1970s to now comprise about 36% of adults.

Geisinger Health in Pennsylvania has expanded a program that gives some of their least-healthy, low income patients free healthy groceries through a program known as Fresh Food Pharmacy. There are now about 65 patients in the program now and the results “have been spectacular,” says Geisinger spokesman Michael Ferlazzo.

Patients have lost weight, reduced their medications and reduced their hemoglobin A1c blood sugar rate by at least three points. One patient cut the level in half — from 16.4 to 8.4 — in four months.